Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
Level 1 (Visual Inspection overview of Area)
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All tools are picked up from working areas when not in use.
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Only essential and non-broken tools are located in work area. All others are removed.
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Main walking paths and work areas do not contain immediate safety hazards.
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Have all question above been answered "safe?"
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You may not proceed to level 2-5 until Level 1 is 100%
Level 2
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Sweeping has been noticeably completed.
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No trash is observed laying in work areas, break areas or offices.
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Material spillage or leaks are being controlled (ore spills, oil leaks, carbon leaks are contained/controlled).
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Have all questions above been answered "Safe?"
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You may not proceed to level 3-5 until Level 2 is 100%
Level 3
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Tools/mobile equipment are in designated locations?
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No excess bulk material is accumulated?
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Secondary areas such as tool rooms are passing level 1 and 2.
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Have all above questions been answered "Safe?"
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You may not proceed to level 4-5 until level 3 is 100%.
Level 4
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Does the department have audits and checklists in place to address Level 1, 2, and 3?
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Are employees and management understand the system?
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Are there visual controls such as 5S boards or display communication boards?
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Have all above questions above been answered "yes?"
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You may not proceed to level 5 until level 4 is 100%.
Level 5
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Control boards and display boards are updated regularly and actively being used.
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Employees are knowledgeable of the current scores and understand the program.
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All levels of the department have assigned ownership and they know where their ownership entails.
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Have all above questions above been answered "yes?"
